Annual opioid fatalities have now surpassed the yearly number of deaths from AIDS at the height of that epidemic in the mid-1990s. In 2016 drug overdose deaths numbered 63,000, more than the U.S. death toll from the entire Vietnam War. The trend is terrifying: the problem is getting worse each year.Cities and states reeling from opioid deaths need to give serious consideration to setting up safe injection rooms, which could significantly reduce fatalities. These are places where a drug user can go to consume illegal drugs under the supervision of health workers. They have been used in Europe, Canada and Australia for decades, and evidence and experience there shows they are very effective. This may not seem like an obvious way to fight an abuse epidemic, but there are few other options. While in the U.S., many cities’ efforts to establish such sites have stalled, Philadelphia is now poised to open the country’s first officially sanctioned safe injection site.The misuse of prescription opioids such as OxyContin is inextricably linked with that of street drugs such as heroin. Nearly half of young people who inject heroin started by abusing prescription drugs. Then they turned to the cheaper, more readily available alternative. The path from pills to needles has meant that U.S. deaths from heroin have increased by a factor of five since 2010, topping 15,000 people in 2016. The number of dead is continuing to climb as people overdose on heroin laced with fentanyl, a synthetic opioid that makes heroin much more potent—and thus more deadly.That’s where safe injection sites would come in. At more than 90 such locations in Europe and elsewhere, if someone overdoses at one of these sites, a health worker or other first responder quickly administers an antidote. The injection facilities also have proved they can reduce the transmission of blood-borne infections, partly through needle-exchange programs. They can also save money: in San Francisco, for example, one analysis concluded that for every dollar spent on such sites, $2.33 in emergency medical, law enforcement and other costs would be reduced, producing a yearly net savings of $3.5 million.